Human immunodeficiency virus [HIV] disease
ICD-10 Codes (0)
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Updates & Changes
FY 2026 Updates
New Codes (1)
Revised Codes (2)
Deleted Codes
No codes deleted in this range for FY 2026
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for B20-B20 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 code range B20-B20 is exclusively used for documenting Human Immunodeficiency Virus (HIV) disease. This range encompasses all stages of HIV, from initial exposure and seroconversion to advanced AIDS. It is essential to note that this code is used only when a patient is confirmed to have HIV disease, not merely HIV positive status.
Key Usage Points:
- •B20 is used for both symptomatic and asymptomatic HIV disease.
- •Always code first any associated opportunistic diseases.
- •If a patient is 'HIV positive' but does not have symptoms of HIV disease, use Z21.
- •B20 includes patients with advanced HIV disease or AIDS.
- •B20 should not be used if a patient has been exposed to HIV but has not tested positive.
Coding Guidelines
When to Use:
- ✓When a patient is diagnosed with HIV disease, whether symptomatic or asymptomatic.
- ✓When a patient with HIV disease presents with an opportunistic infection.
- ✓When a patient has advanced HIV disease or AIDS.
- ✓When a patient with HIV disease is receiving antiretroviral therapy.
When NOT to Use:
- ✗When a patient has been exposed to HIV but has not tested positive.
- ✗When a patient is 'HIV positive' but does not have symptoms of HIV disease.
- ✗When a patient is being tested for HIV.
- ✗When a patient has a false positive HIV test.
Code Exclusions
Always verify exclusions with the patient's medical record and provider documentation.
Documentation Requirements
Documentation for B20-B20 should clearly indicate a diagnosis of HIV disease. It should include the stage of the disease, any associated conditions or complications, and the patient's treatment regimen.
Clinical Information:
- •Confirmation of HIV disease diagnosis
- •Stage of HIV disease
- •Associated conditions or complications
- •Treatment regimen
- •Patient's response to treatment
Supporting Evidence:
- •Laboratory test results confirming HIV disease
- •Clinical notes documenting patient's symptoms and treatment response
- •Imaging studies, if applicable
- •Consultation notes from specialists, if applicable
Good Documentation Example:
Patient diagnosed with HIV disease, currently asymptomatic. Regularly receiving antiretroviral therapy. Recent lab results show viral load is well-controlled.
Poor Documentation Example:
Patient has HIV.
Common Documentation Errors:
- ⚠Not specifying the stage of HIV disease
- ⚠Not documenting associated conditions or complications
- ⚠Not indicating the patient's treatment regimen
- ⚠Confusing 'HIV positive' with 'HIV disease'
Range Statistics
Coding Complexity
Coding for B20-B20 requires a solid understanding of HIV disease and its stages, as well as the ability to accurately code associated conditions. It also requires staying current with changes in HIV treatment and terminology.
Key Factors:
- ▸Determining the stage of HIV disease
- ▸Identifying and coding associated conditions
- ▸Understanding the difference between 'HIV positive' and 'HIV disease'
- ▸Keeping up with changes in HIV treatment and terminology
Specialty Focus
B20-B20 is primarily used by infectious disease specialists, but may also be used by primary care providers, hospitalists, and other specialists treating patients with HIV disease.
Primary Specialties:
Clinical Scenarios:
- • Patient with HIV disease presenting with pneumonia.
- • Patient with HIV disease and well-controlled viral load on antiretroviral therapy.
- • Patient with advanced AIDS presenting with opportunistic infection.
- • Asymptomatic patient with HIV disease receiving routine care.
Resources & References
Resources for coding B20-B20 include the ICD-10-CM Official Guidelines for Coding and Reporting, the CDC's HIV Surveillance Report, and the HIV/AIDS Treatment Guidelines from the National Institutes of Health.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- CDC HIV Surveillance Report
- National Institutes of Health HIV/AIDS Treatment Guidelines
Clinical References:
- HIV.gov
- AIDSinfo
Educational Materials:
- AAPC ICD-10 Training
- AHIMA ICD-10 Training
Frequently Asked Questions
What is the difference between 'HIV positive' and 'HIV disease'?
'HIV positive' indicates that a person has been infected with HIV, but does not necessarily have symptoms of HIV disease. 'HIV disease' is used when a person has symptoms of the disease, such as opportunistic infections or a low CD4 count.